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We reported the case of a 9-year-old girl who complained of irritability with sounds, headache, nausea and ease of fatigability, who was successfully treated with the Kampo formulation, ryokito. Her irritability with sound occurred following bilateral ear pain. Her headache, nausea and antipathy towards smells appeared in conjunction with aggravation of this pain symptom. We recognized this patient as having a Ki-distribution imbalance, and so prescribed ryokito as a decoction. Following her use of this formulation, her complaints improved remarkably within about 8 weeks.ryokito, irritableness for sound, antipathy of smell